Study of antihypertensive effect of ramipril alone and in combination with telmisartan

Mustafa Raja, Ajay Kumar Shukla, Astha Agnihotri

Abstract

Background: Hypertension is one of the leading causes of the global burden of disease. Hypertension has been associated with increased risk of cardiovascular diseases, including coronary heart disease (CHD), congestive heart failure (CHF), ischemic and hemorrhagic stroke, renal failure, and peripheral arterial disease. Majority of the hypertensive population are still either untreated or inadequately treated. Aims and objectives of the study were to compare ramipril alone and in combination with telmisartan as an antihypertensive in mild to moderate hypertension.

Methods: This study was a hospital based prospective, comparative randomized, observational study conducted over a period of one year. The subjects of this study had mild to moderate hypertension selected from outpatient department of department of General Medicine of a tertiary care hospital. For the purpose of this study, equal numbers of subjects were randomly allocated equally between two groups: one group on ramipril alone and the other group on combination of ramipril and telmisartan. Patients were assessed for the blood pressure (BP) reduction during follow-up period of 6-months.

Results: Ramipril alone and in combination with telmisartan, both were associated with significant reduction of systolic BP (SBP), diastolic BP (DBP), and mean BP (MBP) from beginning to the end of study. Combination of ramipril with telmisartan was more effective than ramipril in lowering SBP during 4 to 12 weeks but at the end of study both drug groups were found to be equally effective antihypertensive. Both ramipril alone and in combination with telmisartan were equally effective in lowering DBP and MBP from beginning to end of study.

Conclusions: There was a significant reduction of SBP, DBP, and MBP from beginning to the end of study with both ramipril alone and in combination with telmisartan. Ramipril alone and in combination with telmisartan, both were equally effective antihypertensive for mild to moderate hypertension.

European Society of Hypertension-European Society of Cardiology Guidelines Committee 2003 European society of hypertension-European society of cardiology guidelines for the management of arterial hypertension. J Hypertens. 2003;21(6):1011-53.